Human herpesvirus 6 antigenaemia in allogeneic stem cell transplant recipients: impact on clinical course and association with other beta‐herpesviruses

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Abstract
Summary: Human herpesvirus 6 (HHV‐6) antigenaemia was prospectively studied in 58 adult allogeneic stem cell transplant (SCT) recipients. Altogether 42 of 58 recipients (72%) demonstrated HHV‐6 specific antigens in peripheral blood mononuclear cells after SCT, 22 of 36 (61%) when the donor was a sibling and 20 of 22 (91%) when the donor was unrelated. The cumulative incidence of HHV‐6A, HHV‐6B, HHV‐7, and cytomegalovirus antigenaemia during the first 6 months after SCT was 33%, 62%, 44% and 63% respectively. The median day of the onset of each antigenaemia was +24, +4, +59, and +46 after SCT respectively. There were no clinical findings related to HHV‐6A and HHV‐7 antigenaemias. A rash was diagnosed in 10 of 38 (26%) HHV‐6B antigenaemia positive patients during the first month after SCT compared with one of 20 (5%) HHV‐6B negative patients. Of the HHV‐6B antigenaemia cases, six of 10 rashes were treated as acute graft‐versus‐host disease (GVHD) and four of 10 were considered to be of a viral origin. Fifteen patients had acute GVHD diagnosed. Acute GVHD manifested statistically significantly (P = 0·034) earlier in the nine patients with HHV‐6B antigenaemia compared with the six patients who were HHV‐6B negative.